{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T03:21:41Z","timestamp":1780975301734,"version":"3.54.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI 842\/10-2"],"award-info":[{"award-number":["HI 842\/10-2"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["19CVD02"],"award-info":[{"award-number":["19CVD02"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institute of Health","doi-asserted-by":"publisher","award":["R01HL170058"],"award-info":[{"award-number":["R01HL170058"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["25SFRNPCKMS1463897"],"award-info":[{"award-number":["25SFRNPCKMS1463897"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Peripartum cardiomyopathy (PPCM) is an idiopathic form of heart failure occurring in the peripartum phase. Elevated circulating levels of the senescence\u2013associated\u2013secretory\u2013phenotype (SASP) factor Activin-A have been associated with heart failure severity in acute PPCM patients at baseline diagnosis. Here, we investigated Activin-A serum levels in the German PPCM registry in acute PPCM and during left ventricular (LV) recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Clinical data including LV ejection fraction (LVEF) and Activin-A serum levels were assessed at initial diagnosis (baseline [BL]) and during follow-up (FU) at 3 months (M) and 6M in PPCM patients from the German PPCM Registry (n = 151, mean age 33 \u00b1 5 years) compared to postpartum healthy controls (n = 27, mean age 32 \u00b1 5 years). Activin-A serum levels at BL were elevated (404\u2005pg\/ml; interquartile range [IQR]: 197\u2013815, n = 151) compared to healthy postpartum controls (240\u2005pg\/ml, IQR:148\u2013446, n = 27; P &amp;lt; .01) and remained persistently elevated above postpartum healthy controls at 3\u2005M (418\u2005pg\/ml, IQR: 169\u2013806, n = 100) and 6M-FU (520\u2005pg\/ml, IQR: 214\u20131131, n = 104). Activin-A levels at BL did not correlate with LVEF (Spearman r \u00a0= 0.10, P = .2416, n = 139), NT-proBNP (r \u00a0= 0.096, P = .2766, n = 131), CRP (r \u00a0= \u22120.0008, P = .9933; n = 110) or PPCM biomarker plasminogen-activator-inhibitor-1 (PAI-1) (r \u00a0= 0.095, P = .3273, n = 109). The majority of PPCM patients showed LV recovery 6M after initial diagnosis, indicated by improved LVEF (PPCM BL: 25%, IQR: 20\u201333, n = 152; 6M-FU: 52% IQR: 45\u201356, n = 128, P &amp;lt; .0001). Activin-A levels did not differ between full or incomplete LV recovery, or between patients with hypertensive pregnancy disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In PPCM patients from the German PPCM registry Activin-A serum levels were elevated at diagnosis, remained persistently high after 3M- and 6M-FU but were not associated with LV recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag062","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:53:19Z","timestamp":1771505599000},"source":"Crossref","is-referenced-by-count":1,"title":["Elevated Activin-A serum levels in patients with acute peripartum cardiomyopathy and during left ventricular recovery"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1669-5911","authenticated-orcid":false,"given":"Thomas","family":"Gausepohl","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9130-9470","authenticated-orcid":false,"given":"Tobias Jonathan","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1879-7721","authenticated-orcid":false,"given":"Tobias","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-3540","authenticated-orcid":false,"given":"Dominik","family":"Berliner","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Kasten","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6999-6868","authenticated-orcid":false,"given":"Jason","family":"Roh","sequence":"additional","affiliation":[{"name":"Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6065-9649","authenticated-orcid":false,"given":"Denise","family":"Hilfiker-Kleiner","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]},{"name":"President, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9341-117X","authenticated-orcid":false,"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5479-2275","authenticated-orcid":false,"given":"Melanie","family":"Ricke-Hoch","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Carl-Neuberg-Str., 30625 Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"2026030611570645500_xvag062-B1","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1002\/ejhf.1493","article-title":"Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur J Heart 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